Pneumonectomy
A pneumonectomy (or pneumectomy) is a surgical procedure to remove a lung. Removal of just one lobe of the lung is specifically referred to as a lobectomy, and that of a segment of the lung as a wedge resection (or segmentectomy).
Indications
The most common cause for a pneumonectomy is to excise tumourous tissue arising from lung cancer. Other indications for lobectomy include a solitary pulmonary nodule (the possibility of undiagnosed small-cell cancer in this instance is not necessarily a reason for avoiding thoracotomy), or bronchiectasis where other forms of treatment have failed, particularly if it is localised and recurrent hemoptysis is present. In the days prior to the use of antibiotics in tuberculosis treatment, tuberculosis was sometimes treated surgically by pneumonectomy.
It is clear that the operation will reduce the respiratory capacity of the patient; before conducting a pneumonectomy, the surgeon will evaluate the ability of the patient to function after the lung tissue is removed. After the operation, patients are often given an incentive spirometer to help exercise their remaining lung and to improve breathing function.
A rib or two is sometimes removed to allow the surgeon better access to the lung.
Types
There are two types of pneumonectomy:
1. Simple pneumonectomy: removal of just the affected lung
2. Extrapleural pneumonectomy (EPP): removal of the affected lung, plus part of the diaphragm, the parietal pleura (lining of the chest) and the pericardium (lining of the heart) on that side.[1] The linings are replaced by Gore-Tex in this radical and painful surgery that is used primarily for treatment of malignant mesothelioma. This technique produces the best long-term survival rates for this serious and fatal disease.[2]
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